Hepatectomy
What is Hepatectomy ?
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Why do you need Hepatectomy ?
Hepatectomy is indicated for:
- Liver cancer:
- Hepatocellular carcinoma (HCC, 75–85% of primary liver cancers; common in India due to hepatitis B/C, 5–10 per 100,000).
- Metastatic liver cancer (e.g., from colorectal cancer, 50% of cases spread to liver).
- Cholangiocarcinoma (bile duct cancer, 10–20% of primary liver cancers).
- Benign conditions:
- Hepatic adenomas (benign tumors, risk of rupture or malignancy; 1–2 per 100,000).
- Hemangiomas (if symptomatic, e.g., pain or bleeding).
- Liver cysts (if large and symptomatic).
- Other indications:
- Trauma (e.g., liver laceration from accidents).
- Living donor liver transplant (removal of liver portion for donation).
- Associated treatments:
- Often preceded by portal vein embolization (PVE) to grow the remaining liver pre-op.
- May include chemotherapy (pre- or post-op) for cancer.
- Timing:
- Performed in adults (average age 50–70 years for HCC); urgency depends on diagnosis (e.g., immediate for trauma).
The procedure aims to remove diseased tissue, preserve liver function, and allow regeneration of the remaining liver, often using open or minimally invasive techniques.
Why Do Hepatectomy Costs Vary in Philippines?
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Hepatectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Imaging: CT/MRI to assess tumor size, location, and liver volume (future liver remnant, FLR, must be >20–30% for safety).
- Blood tests: Liver function (ALT, AST, bilirubin), clotting profile (INR); hepatitis screening.
- Biopsy (if needed): Confirms cancer type.
- Liver function tests: Child-Pugh score, MELD score to assess surgical risk.
- Preparation: PVE (if FLR small); correct coagulopathy or jaundice pre-op.
- Consent: Risks, including liver failure, are explained.
- Assessment:
- Surgical Techniques:
- Hepatectomy:
- Performed under general anesthesia, lasting 3–6 hours.
- Types:
- Partial hepatectomy: Removes a segment/wedge (e.g., segmentectomy) or lobe (e.g., right/left hepatectomy); for localized tumors.
- Total hepatectomy: Entire liver removed; only in transplant setting (replaced with donor liver).
- Approaches:
- Open hepatectomy: Large incision (15–30 cm) in abdomen (chevron or midline); for large tumors or complex cases.
- Laparoscopic hepatectomy: 4–5 small incisions (5–10 mm); camera and instruments used; for smaller tumors.
- Robotic hepatectomy: Similar to laparoscopic but with robotic assistance; offers precision.
- Process:
- Liver mobilized; blood vessels to affected area clamped (Pringle maneuver) to reduce bleeding.
- Liver parenchyma resected using ultrasound guidance (to avoid major vessels).
- Tumor removed with margin (1 cm for cancer); remaining liver sealed to prevent bile leaks.
- Closure: Sutures/staples; drains placed to prevent fluid buildup.
- Intraoperative Tools:
- Intraoperative ultrasound: Identifies tumor margins.
- Cavitron Ultrasonic Surgical Aspirator (CUSA): Dissects liver tissue.
- Argon beam coagulator: Controls bleeding.
- Hepatectomy:
- After Surgery:
- Hospital stay: 5–10 days.
- Care: ICU for 1–3 days; monitor liver function (bilirubin, INR); drains for 3–5 days.
- Pain management: Moderate pain for 5–7 days; managed with epidural or IV painkillers.
- Instructions: Avoid heavy lifting for 6–8 weeks; nutritional support (high-protein diet) for liver regeneration.
Recovery After Hepatectomy
- Hospital Stay: 5–10 days.
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 5–7 days; resolves in 2–3 weeks.
- Liver function: Monitored via blood tests (INR, bilirubin); liver regenerates to 70–80% of original size in 4–6 weeks.
- Activity: Avoid strenuous activity for 6–8 weeks; light walking within 3–5 days to prevent clots.
- Drains/Incision: Drains removed in 3–5 days; sutures removed in 10–14 days; scar fades in 6–12 months.
- Diet: High-protein, low-fat diet to support regeneration; small, frequent meals.
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years (cancer recurrence risk).
- Imaging: CT at 3–6 months to monitor for recurrence; liver function tests ongoing.
Most resume normal activities in 6–8 weeks; full recovery takes 3–6 months. Success rate: 90–95% for complete tumor removal in early-stage HCC; 5-year survival for HCC varies (30–50%, depending on stage and cirrhosis).
Risks and Complications
- Surgical Risks:
- Bleeding (5–10%): Liver is vascular; may need transfusion.
- Infection (5–10%): Wound or intra-abdominal; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to general anesthesia; rare in healthy patients.
- Post-Surgery:
- Liver failure (2–5%): If FLR too small or underlying liver disease (e.g., cirrhosis); may need transplant.
- Bile leak (3–5%): From cut liver surface; may need drainage or reoperation.
- Ascites (5–10%): Fluid buildup in abdomen; managed with diuretics.
- Pleural effusion (2–5%): Fluid in chest; may need drainage.
- Long-Term:
- Recurrence (30–50%): HCC often recurs; needs regular monitoring.
- Liver dysfunction (5–10%): If cirrhosis present; managed with supportive care.
Report fever, severe pain, jaundice, or abdominal swelling promptly.
Frequently Asked Questions (FAQs)
What causes the need for hepatectomy?
Liver cancer (HCC, metastatic), benign tumors (adenomas, hemangiomas), trauma, or donor transplant.
Can I avoid hepatectomy?
Yes, if small/non-malignant: Ablation (e.g., RFA) or embolization; surgery needed for large tumors, cancer, or symptomatic lesions.
Is hepatectomy painful?
Moderate pain for 5–7 days, managed with medication; resolves in 2–3 weeks.
How soon can I resume normal activities?
Light activities: 2–3 weeks; full recovery: 3–6 months; avoid strenuous activity for 6–8 weeks.
Is hepatectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, jaundice, or abdominal swelling.
Will my liver function normally after surgery?
Yes, in most cases: Liver regenerates in 4–6 weeks; function preserved if FLR adequate and no cirrhosis.
Lifestyle changes post-surgery?
High-protein diet, avoid alcohol (protects liver), monitor for recurrence, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Hepatectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.